comfortdentalglencove.com

{
  "type": "object",
  "properties": {
    "first_name": {
      "type": "string",
      "description": "Patient's first name (formal/legal name preferred)."
    },
    "last_name": {
      "type": "string",
      "description": "Patient's last name."
    },
    "phone": {
      "type": "string",
      "description": "Phone number with area code where the office can call or text the patient, e.g. \"(516) 555-1234\"."
    },
    "email": {
      "type": "string",
      "description": "Optional email address."
    },
    "new_or_existing": {
      "type": "string",
      "enum": [
        "New Patient",
        "Existing Patient"
      ],
      "description": "Optional. Whether the patient is new to the practice or an existing patient."
    },
    "reason_for_visit": {
      "type": "string",
      "enum": [
        "New Patient Exam & Cleaning",
        "Dental Implants",
        "Cosmetic Dentistry / Whitening",
        "Crowns & Bridges",
        "Root Canal",
        "Orthodontics / Braces",
        "Pediatric / Children's Dentistry",
        "Dentures & Partials",
        "Periodontal / Gum Treatment",
        "Tooth Extraction",
        "Emergency / Tooth Pain",
        "Other"
      ],
      "description": "Optional. Reason for visit; must be exactly one of the form options."
    },
    "insurance_provider": {
      "type": "string",
      "description": "Optional. Insurance company name only (e.g. \"Delta Dental\", \"Aetna\"). Never include member, subscriber, group, or policy numbers."
    },
    "preferred_time_window": {
      "type": "string",
      "description": "Optional. Preferred day/time in plain words, e.g. \"Tuesday, November 10 - 9:30 AM to 11:00 AM\" or \"weekday mornings\". Office hours: Mon 9-5, Tue-Thu 9-6, Fri 10-5, closed weekends. Not confirmed until the office follows up."
    },
    "notes": {
      "type": "string",
      "description": "Optional. Brief scheduling notes or questions (max 1000 characters). Do not include medical history, date of birth, ID numbers, or payment details."
    }
  },
  "required": [
    "first_name",
    "last_name",
    "phone"
  ]
}